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Questions and Answers

Which method is 98% effective when used correctly for determining fertility?

  • Cycle Beads Method
  • Standard Days Method
  • Billings Ovulation Method (correct)
  • Cervical Mucus Method

What menstrual cycle length must be present to use the Standard Days Method?

  • 31 to 34 days
  • Less than 26 days
  • 26 to 32 days (correct)
  • 20 to 25 days

What color bead signifies a fertile day in the Cycle Beads method?

  • Red
  • White (correct)
  • Brown
  • Yellow

What should be done on the first day of the menstrual cycle in the Cycle Beads method?

<p>Put the ring on the red bead (D)</p> Signup and view all the answers

What is the effectiveness rate of the Standard Days Method with typical use?

<p>88% (A)</p> Signup and view all the answers

Which of the following is NOT an advantage of Fertility-Awareness Based Methods?

<p>Requires follow-up medical appointments (C)</p> Signup and view all the answers

Which of the following actions is recommended when using Cycle Beads?

<p>Move the ring every morning upon waking up (D)</p> Signup and view all the answers

What signs indicate that a woman may be fertile according to the methods mentioned?

<p>Breast engorgement and unilateral lower abdominal pain (B)</p> Signup and view all the answers

What is considered the right age for a woman to get pregnant according to the guidelines?

<p>20-35 years old (C)</p> Signup and view all the answers

How frequently should pregnancies ideally occur according to the recommended guidelines?

<p>Once every 3 to 5 years (A)</p> Signup and view all the answers

What is a Home Base Mother’s Record (HBMR) primarily used for?

<p>Care of mothers in community health nursing (C)</p> Signup and view all the answers

Which of the following laws emphasizes integration of family planning into all curricular programs?

<p>LOI 47 (A)</p> Signup and view all the answers

What approach is recommended to establish relationships with other agencies in family planning?

<p>Multi-Sectoral Approach (C)</p> Signup and view all the answers

Which of the following statements is true regarding a woman’s pregnancy status?

<p>Breastfeeding within six months and not menstruating can indicate she is not pregnant. (B)</p> Signup and view all the answers

Which contraceptive method is noted as the most effective?

<p>Abstinence (C)</p> Signup and view all the answers

What is a key provision of the Responsible Parenthood and Reproductive Health Act of 2012?

<p>Providing freedom of choice in family planning decisions (B)</p> Signup and view all the answers

What is a disadvantage of Fertility-Awareness Based Methods?

<p>They may inhibit sexual spontaneity. (A)</p> Signup and view all the answers

Which condition must be met for a woman to qualify for the Lactational Amenorrhea Method (LAM)?

<p>The infant must be less than six months old. (D)</p> Signup and view all the answers

How does the Lactational Amenorrhea Method (LAM) primarily prevent pregnancy?

<p>By preventing ovulation. (B)</p> Signup and view all the answers

What is required for accurate use of fertility-awareness methods?

<p>Close attention to body changes. (D)</p> Signup and view all the answers

Which of the following is NOT a criterion for the use of LAM?

<p>Infant receives appropriate supplementation. (C)</p> Signup and view all the answers

What must be true about the woman for effective use of the Standard Days Method (SDM)?

<p>Her cycle length must be between 26-32 days. (C)</p> Signup and view all the answers

How long does it typically take to accurately identify the fertile period when using fertility-awareness methods, excluding SDM?

<p>Two to three cycles. (A)</p> Signup and view all the answers

What is a limitation regarding sexual intercourse for women using fertility-awareness methods?

<p>They may need to abstain during certain periods. (B)</p> Signup and view all the answers

What is one of the possible side effects of missing a progestin-only pill?

<p>Spotting or breakthrough bleeding (B)</p> Signup and view all the answers

What should a woman do if she misses taking her progestin-only pill by more than three hours?

<p>Abstain from sex or use a barrier method for 48 hours (B)</p> Signup and view all the answers

What hormone does the progestin-only injectable Depot medroxyprogesterone acetate (DMPA) primarily release?

<p>Progesterone (B)</p> Signup and view all the answers

Which progestin-only pill is available in a lower dosage of 0.5 mg?

<p>Lynestrenol (D)</p> Signup and view all the answers

What is the main mechanism by which progestin-only injectables provide contraception?

<p>Thickening cervical mucus and inhibiting ovulation (D)</p> Signup and view all the answers

When should progestin-only pills be initiated for menstruating women?

<p>Within the first five days of the menstrual cycle (A)</p> Signup and view all the answers

What is the effectiveness rate of progestin-only injectables if perfectly used?

<p>99.7% (C)</p> Signup and view all the answers

What is recommended for women starting progestin-only pills if they do not start within five days of their menstrual cycle?

<p>Abstain from sexual intercourse or use a backup method for two days (C)</p> Signup and view all the answers

What is a common reason for a condom to break during use?

<p>Inadequate vaginal lubrication (C)</p> Signup and view all the answers

Which of the following practices can weaken latex condoms?

<p>Applying mineral and vegetable oils as lubricants (D)</p> Signup and view all the answers

How long should a diaphragm or cervical cap be left in place after coitus for optimal effectiveness?

<p>6 hours (A)</p> Signup and view all the answers

What is a significant feature of the Copper T intrauterine device (IUD)?

<p>Prevents sperm motility through copper ions (C)</p> Signup and view all the answers

What action should be taken after ejaculation when using a condom?

<p>Hold the condom at the base while withdrawing (D)</p> Signup and view all the answers

Which of the following is a potential drawback of male condom use?

<p>May decrease sensitivity for some men (D)</p> Signup and view all the answers

What should be checked on a condom package before use?

<p>The manufactured or expiration date (A)</p> Signup and view all the answers

Which type of IUD is medicated with a steroid hormone?

<p>Mirena (D)</p> Signup and view all the answers

What is the primary function of the copper bands on the TCu380A IUD?

<p>To release copper high in the fundus of the uterus (D)</p> Signup and view all the answers

Which of the following statements accurately describes a characteristic of an IUD?

<p>Fertility returns immediately after removal (A)</p> Signup and view all the answers

Which factor may contribute to the expulsion of an IUD?

<p>Nulliparity and severe dysmenorrhea (B)</p> Signup and view all the answers

What is the primary purpose of a vasectomy?

<p>To sterilize men by cutting and tying the vas deferens (B)</p> Signup and view all the answers

Which procedure describes a no scalpel vasectomy?

<p>Making a small puncture on the scrotum without a scalpel (D)</p> Signup and view all the answers

How effective is a vasectomy when performed correctly?

<p>99.9% effective (B)</p> Signup and view all the answers

What is a potential side effect experienced after a vasectomy?

<p>Pain in the scrotum, swelling, and bruising (B)</p> Signup and view all the answers

What precaution should be taken after a vasectomy procedure?

<p>Use an alternative contraceptive for at least three months (A)</p> Signup and view all the answers

Flashcards

Responsible Parenthood

The right to decide freely and responsibly about having children, including the number and spacing of pregnancies.

Reproductive Health Act of 2012

The law that guides responsible parenthood and reproductive health in the Philippines. (Republic Act No. 10354).

Safe Pregnancy Age

The recommended age range for pregnancy is 20 to 35 years old..

Pregnancy Interval

Recommended time between pregnancies, typically 3-5 years.

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Home Base Mother's Record (HBMR)

A record used by Care for mothers in community health.

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Natural Contraception

Methods of birth control that do not use hormones or devices, like fertility awareness.

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Artificial Contraception

Methods of birth control that involve devices, hormones, or surgery, like the IUD or pill.

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Zero unmet need for family planning

A goal to ensure everyone has access to the family planning they want.

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Standard Days Method (SDM)

A fertility awareness method that uses a predictable, 26-32 day menstrual cycle length to identify fertile and infertile periods.

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Cycle Beads

A tool used with the SDM method to track the fertile and infertile days of the menstrual cycle.

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Fertile period

Days when a woman is most likely to get pregnant.

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Infertile period

Days when a woman is least likely to get pregnant.

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Menstrual cycle length

Number of days between the first day of one menstrual period and the first day of the next.

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Cervical mucus method

A fertility awareness method that monitors changes in cervical mucus to identify fertile and infertile periods

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Fertility Awareness Methods

Methods that track signs of fertility to avoid or achieve pregnancy.

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Efficacy of SDM (typical use)

The effectiveness of the Standard Days Method when used in the average way—not perfectly.

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What is LAM?

Lactation Amenorrhea Method (LAM) is a natural family planning method that uses breastfeeding to prevent pregnancy.

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What are the criteria for LAM?

To use LAM, the woman needs to exclusively breastfeed her infant under six months old and not have her period back.

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Exclusively breastfeed?

The baby only receives breast milk and no other liquids or foods, excluding essential medications like vitamins or antibiotics.

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Amenorrhea?

The woman is not having her menstrual cycle yet. Spotting in the first few weeks after birth doesn't count.

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When does LAM become less effective?

LAM's effectiveness decreases after six months postpartum, as ovulation resumes in many women.

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How does LAM work?

LAM stops ovulation, the release of eggs from the ovaries.

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What happens if the criteria for LAM are not met?

If any of the criteria is not met, it is no longer considered LAM, and other methods of family planning should be used.

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What is the main advantage of LAM?

It's a natural method free of hormones, devices, or interventions, but it only works under specific conditions.

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Condoms: Common Mistakes

Using a condom incorrectly can lead to failure. Mistakes include not pressing the tip, wearing it inside-out, and stretching/pulling it, which weakens the latex.

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Condoms & Sensitivity

Some men experience decreased sensitivity when using condoms.

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Condom Application

Before using a condom, check the expiration date and ensure it's not damaged. After ejaculation, hold the base of the penis while withdrawing to prevent it from slipping off.

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What are POPs?

Progestin-only pills are a type of hormonal contraception that uses only progestin, a synthetic hormone similar to progesterone, to prevent pregnancy.

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How do Cervical Caps Work?

Cervical caps and diaphragms prevent sperm from passing through the cervix. They are more effective with spermicide.

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How many types of POPs exist?

There are two main types of POPs: 1. Lynestrenol (0.5 mg) 2. Desogestrel (75 ug)

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IUD: Mechanism

Copper IUDs prevent fertilization by releasing copper ions that decrease sperm motility and function. This prevents sperm from reaching the egg.

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IUD: Types

There are two main types of IUDs: copper-bearing and hormone-releasing. Copper-bearing IUDs include the TCu380A (Copper T), Multiload, and Nova T. Hormone-releasing IUDs have levonorgestrel, like Mirena®.

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Starting POPs: Menstruating

If you are menstruating, you can start taking POPs within the first five days of your menstrual cycle, preferably on the first day. This ensures maximum effectiveness.

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Starting POPs: Not Menstruating

If you are not menstruating, you can start taking POPs at any time of your cycle, but only if you are reasonably sure you are not pregnant. If you are not within the first five days, use a backup method for the next two days.

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IUD: Effectiveness

Copper IUDs, like TCu380A, are effective for at least 12 years and have a less than 1% pregnancy rate.

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Missed POP pills: What to do?

If you miss one or more POP pills, you may experience spotting or breakthrough bleeding, and your risk of pregnancy increases. Restart taking the pills as soon as possible.

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IUD: Replacement

Copper IUDs should be replaced or removed 12 years after insertion, even though the FDA approval is for 10 years.

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Missed POP pills: More than 3 hours?

If you missed taking your pills for more than three hours, use a barrier method of contraception for the next 48 hours after restarting the pills.

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What is DMPA?

Depot medroxyprogesterone acetate (DMPA) is a 3-month injectable contraceptive, often known as Depo-Provera. It contains 150 mg of progestin, released slowly into the bloodstream for long-term effectiveness.

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How do POIs work?

Progestin-only injectables (POIs) work by inhibiting ovulation, making it harder for the egg to be released. They also thicken cervical mucus, making sperm penetration difficult.

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What is an IUD?

An Intrauterine Device (IUD) is a small, T-shaped device placed inside the uterus to prevent pregnancy.

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How does a TCu380A IUD work?

The TCu380A IUD is a type of copper IUD. It releases copper ions into the uterus, which prevents sperm from fertilizing an egg.

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How long does a TCu380A IUD last?

A TCu380A IUD is effective for up to 12 years after insertion.

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What are the advantages of an IUD?

IUDs are highly effective, reversible, and convenient. They have no systemic side effects and allow for immediate fertility after removal.

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What is vasectomy?

Vasectomy is a permanent male sterilization procedure that involves cutting and sealing the vas deferens, the tubes that carry sperm.

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How effective is vasectomy?

Vasectomy is highly effective, with a success rate of over 99.9% when performed correctly.

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When does vasectomy become effective?

Vasectomy is not immediately effective. It takes about three months and requires a semen check to confirm.

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What are the pros and cons of vasectomy?

Advantages include high effectiveness, increased sexual enjoyment, and reduced worry about pregnancy. Disadvantages include a lack of immediate effectiveness and the possibility of reversal surgery being complex, expensive, or unavailable.

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Study Notes

National Family Planning Program (NFPP)

  • Vision: Filipino women and men achieve their desired family size and fulfill reproductive health and rights through universal access to quality family planning information and services.
  • Mission: In line with the Department of Health’s FOURmula One Plus strategy and Universal Health Care framework, the National Family Planning Program is committed to providing responsive policy direction and ensuring access of Filipinos to medically safe, legal, non-abortifacient, effective, and culturally acceptable modern family planning (FP) methods.
  • Objectives:
    • Increase modern Contraceptive Prevalence Rate (mCPR) among all women from 24.9% in 2017 to 30% by 2022
    • Reduce the unmet need for modern family planning from 10.8% in 2017 to 8% by 2022

Six Facets of Family Planning Quality Care

  • Choice of method
  • Technical competence of providers
  • Informing and counseling clients
  • Interpersonal relations
  • Mechanisms to encourage continuation
  • Appropriateness and acceptability of services

Guiding Principles of the NFPP

  • 1. Respect for the Sanctity of Life: Aims to prevent abortion, therefore saving lives of women and children. Methods must be medically and legally permissible. Consideration must be given regardless of client's sex, number of children, sexual orientation, moral background, occupation, socio-economic status, cultural or religious beliefs.

  • 2. Respect for Human Rights: Use only medically and legally permissible methods.

  • 3. The Freedom of Choice and Voluntary Decision: Couples and individuals should make family planning decisions based on informed choice, including their own moral, cultural, or religious beliefs.

  • 4. Respect for the Rights of Clients to Determine Their Desired Family Size: Couples and individuals have the right to decide freely and responsibly the number and spacing of their children.

  • Republic Act No. 10354: Responsible Parenthood and Reproductive Health Act of 2012 (RPRH Law)
  • Executive Order No. 12, s. 2017: Attaining and Sustaining "Zero Unmet Need for Modern Family Planning" Through the Strict Implementation of the Responsible Parenthood and Reproductive Health Act, Providing Funds Therefore, and for other Purposes

Safe Pregnancy

  • Right age to be pregnant: 20-35 years old
  • Right interval of pregnancy: once in 3 or 5 years
  • Home Base Mother's Record (HBMR): record used for care of mothers in CHN
  • Policies:
    • Non-coercive (freedom of choice)
    • Integration of Family Planning in all Curricular Programs (LOI 47)
    • Multi-sectoral approach: establishing relationships with other agencies (e.g., WHO, UNICEF, USAID)

How to be Reasonably Sure a Client is Not Pregnant

  • Series of questions to determine a client's potential pregnancy risk
  • Proceed to the next answer option determined as YES or NO
  • Outcomes based on answers

Fertility Awareness-Based Methods (FAB)

  • Focus is on awareness of fertile and infertile periods in a woman's menstrual cycle.
  • Techniques included:
    • Cervical mucus (Billing's Method, Two-Day Method)
    • Basal Body Temperature (BBT)
    • Sympto-Thermal Method (STM)
    • Standard Days Method (SDM) / Calendar Method

Lactation Amenorrhea Method (LAM)

  • Breastfeeding as a temporary family planning method.
  • Criteria:
    • Exclusive breastfeeding (no supplementary food/liquids)
    • Very small amount of water, vitamins, or antibiotics (as medically prescribed).
    • Use of both breasts on demand, with no more than a four-hour interval between daytime feeds, and no more than a six-month gap between each feeding.
    • Lack of return of menstruation.

Hormonal Contraceptive Methods

  • Low-dose combined estrogen-progestin pills (COCs)
    • Contain hormones similar to a woman's natural hormones (estrogen and progesterone).
    • Prevent ovulation by suppressing follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
    • Thickens the cervical mucus, making it hard for sperm to pass.
    • Two types of COCs: 21 pills and 28 pills. 28 pills include some inactive/reminder pills.
  • Progestin-only pills (POPs):
    • Contain a small amount of progestin.
    • Prevents ovulation.
    • Causes Cervical mucus thickening which makes sperm penetration difficult
    • Effective for breastfeeding.
  • Progestin-only injectable contraceptives (POIs):
    • Given intramuscualrly.
    • Three-month/90-day interval contraception.
    • Hormone slows released and provides a safe/highly effective contraception.
    • Two types of POIs: Depot medroxyprogesterone acetate (DMPA) and Norethisterone enanthate (NET-EN).

Progestin Subdermal Implants (PSI)

  • Norplant/Implanon - inhibits ovulation
  • Effective for 3 years
  • Implanted capsules under a small surgical incision in the upper inner arm.
  • Removal available anytime.

Barrier Methods: Condoms

  • Prevent sperm entry.
  • Some spermicidal condoms are helpful.
  • Highly effective when used correctly.
  • Protects against STIs.

Barrier Methods: Cervical Caps and Diaphragms

  • Prevent sperm from entering the cervix.

Intrauterine Device (IUD)

  • Copper-bearing IUDs (e.g., TCu380A) prevent fertilization.
  • Copper ions reduce sperm motility and function.
  • Effective for at least 12 years.

Permanent Methods: Vasectomy

  • Male sterilization.
  • Tying and cutting a segment of the vas deferens.
  • Effective at 99.9%.
  • Requires proper care/use after procedure.
  • Increased sexual enjoyment once procedure is complete.

Permanent Methods: Bilateral Tubal Ligation (BTL)

  • Female sterilization.
  • Incision in the abdomen to tie/cut the fallopian tubes
  • Blocks sperm access to eggs.
  • High effectiveness rate.

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